Clinical and microbiological impact of inhaled tobramycin treatment on cystic fibrosis patients with Pseudomonas aeruginosa

Authors : Francesca DİCKHAUS, Mutasim Abu HASAN, Elizabeth TREMBLAY, Kenneth KLİNKER, Kenneth RAND, Stacy G BEAL

Pages : 178-185

Doi:10.5799/jmid.368802

View : 7 | Download : 3

Publication Date : 2017-12-01

Article Type : Research Paper

Abstract :Clinical and Microbiological Impact of Inhaled Tobramycin Treatment on Cystic Fibrosis Patients with Pseudomonas aeruginosa Francesca Dickhaus 1 , Mutasim Abu Hasan 2 , Elizabeth Tremblay 3 , Kenneth Klinker 4 , Kenneth Rand 5,6 Stacy G. Beal 5 1 University of Florida College of Medicine, Gainesville, Florida, USA 2 University of Florida College of Medicine, Department of Pediatrics, Pediatric Pulmonary and Allergy Division, Gainesville, Florida, USA 3 UF Health Shands Hospital, Department of Infection Control, Gainesville, Florida, USA 4 UF Health Shands Hospital, Department of Pharmacy Practice, Gainesville, Florida, USA 5 University of Florida College of Medicine, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, Florida, USA 6 University of Florida College of Medicine, Department of Internal Medicine, Division of Infectious Diseases and Global Medicine, Gainesville, Florida, USA   ABSTRACT Objective: Patients’ with cystic fibrosis respiratory systems become colonized with pathogens as early as the first year of life.  Some organisms are associated with a decline in pulmonary function and shortened survival, such as a mucoid strain of Pseudomonas aeruginosa insert ignore into journalissuearticles values(PA);. Methods: We conducted a four year retrospective chart review study examining 158 pediatric and adult cystic fibrosis patients treated at an academic, tertiary care institution to compare patients treated by different antimicrobial regimens. Results: A higher proportion of mucoid PA study patients received alternate-monthly tobramycin therapy insert ignore into journalissuearticles values(83.3%);, compared to those with non-mucoid PA insert ignore into journalissuearticles values(62.5%);; although a large percentage of patients who had never had a mucoid PA infection were also receiving alternate-monthly tobramycin. Patients who had a mucoid PA infection had more hospitalizations and for longer periods of time than patients who had a non-mucoid PA infection; both mucoid and non-mucoid PA patients were hospitalized more often than patients who had never had a PA infection. We additionally found patients with mucoid PA infections to have strains that were either resistant or had intermediate resistance to tobramycin. Similar trends in resistance were not seen in patients who only received intermittent treatments with tobramycin. Conclusions Our findings on increased rates of infection with both Aspergillus insert ignore into journalissuearticles values(in the alternate-monthly inhaled tobramycin group); and NTM insert ignore into journalissuearticles values(in the overall patient population); comparative to international averages were also interesting, and open the doors to future research regarding CF patients with these infections. J Microbiol Infect Dis 2017; 7insert ignore into journalissuearticles values(4);:178-185 Keywords: Cystic fibrosis, Pseudomonas, Tobramycin
Keywords : HIV, HCV, Genotype, Co infection, Viral load